The cost of inpatient burn management in Nepal

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The cost of inpatient burn management in Nepal


JournalBurns
Article typeJournal research article – Clinical research
Publication date – Feb – 2021
Authors – Ak Narayan Poudela, Patricia Pricebc, Julia Lowina, Rojina Shilpakard, Kiran Nakarmie, Tom Potokar
KeywordsBurn Bottom-up approach, Cost of Illness, Methodology, Nepal
Open access – Yes
SpecialityPlastic surgery, Trauma surgery
World region Southern Asia
Country: Nepal
Language – English
Submitted to the One Surgery Index on February 16, 2021 at 7:18 am
Abstract:

Abstract
Introduction
The management of burns is costly and complex with inpatient burns accounting for a high proportion of the costs associated with burn care. We conducted a study to estimate the cost of inpatient burn management in Nepal. Our objectives were to identify the resource and cost components of the inpatient burn care pathways and to estimate direct and overhead costs in two specialist burn units in tertiary hospitals in Nepal.

Methods
We conducted fieldwork at two tertiary hospitals to identify the cost of burns management in a specialist setting. Data were collected through semi-structured in-depth interviews (IDIs) and focus group discussions (FGDs) with burn experts; unit cost data was collected from hospital finance departments, laboratories and pharmacies. The study focused on acute inpatient burn cases admitted to specialist burn centres within a hospital-setting.

Results
Experts divided inpatient burn care pathways into three categories: superficial partial-thickness burns (SPT), mixed depth partial-thickness burns (MDPT) and full thickness burns (FT). These pathways were confirmed in the FGDs. A ‘typical’ burns patient was identified for each pathway. Total resource use and total direct costs along with overhead costs were estimated for acute inpatient burn patients. The average per patient pathway costs were estimated at NRs 102,194 (US$ 896.4), NRs 196,666 (US$ 1725), NRs 481,951 (US$ 4,227.6) for SPT, MDPT and FT patients respectively. The largest cost contributors were surgery, dressings and bed charges respectively.

Conclusion
This study is a first step towards a comprehensive estimate of the costs of severe burns in Nepal.

OSI Number – 20934

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